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1750295564 NPI number — JOHNSON PROSTHETICS & ORTHOTICS LLC

NPI Number: 1750295564
Health Care Provider/Practitioner: JOHNSON PROSTHETICS & ORTHOTICS LLC

Information about “1750295564” NPI (JOHNSON PROSTHETICS & ORTHOTICS LLC) exists in 1750295564 in HTML format HTML  |  1750295564 in plain Text format TXT  |  1750295564 in PDF (Portable Document Format) PDF  |  1750295564 in an XML format XML  formats.

NPI Number : 1750295564 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750295564",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "JOHNSON PROSTHETICS & ORTHOTICS LLC",
    "ParentOrgTIN": null,
    "OrgName": "JOHNSON PROSTHETICS & ORTHOTICS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1742 E JOYCE BLVD STE 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAYETTEVILLE",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72703-5260",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-658-7811",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6601 PHOENIX AVE STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT SMITH",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72903-5092",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "479-222-9932",
    "PracticeLocationAddressFaxNumber": "479-222-2278",
    "EnumerationDate": "09/29/2026",
    "LastUpdateDate": "09/29/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JOHNSON",
    "AuthorizedOfficialFirstName": "GREG",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CPO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "479-485-3366",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "335E00000X",
          "TaxonomyName": "Prosthetic/Orthotic Supplier",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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